Procedure Kits: Where Common Sense Makes Financial Sense

PROCEDURES WHERE KITS HELP

  • Vascular Access Devices
    • PIV Starts
    • CVC Insertion
    • PICC Lines
  • Epidurals
  • Dressing Changes
  • Surgical Procedures

In our last blog, we reviewed how standardization of procedure kits can help your facility by increasing overall compliance to best practices. Yet another advantage of procedures kits is the financial benefit. A case in point is a study of phlebitis and infiltration rates within an institution following the conversion to a standard intravenous (IV) start kit, which showed dramatic effects by not only improving outcomes but decreasing costs as well.1

Nursing departments in this 700-bed facility tested a variety of IV starter kits and determined their best choice for the study. The kit they selected featured a window dressing, a prep of 2% chlorhexidine gluconate (CHG) with 70% isopropyl alcohol, catheter securement cushions, a tape strip, a 2″ x 2″ gauze pad, a latex-free tourniquet, and an extension set with needleless valve.

Hands-on training in the appropriate use of the kit was provided to hospital staff to achieve consistent usage. Outcomes were monitored by assessing phlebitis and infiltration rates at 6-month intervals on 250 patients per assessment.

The clinical results of implementing a standardized protocol/procedure kit not only met but exceeded the hospital staff’s objectives1:

  • Phlebitis rates were virtually eliminated
  • Infiltration rates were zero
  • Dwell times were extended from 72 hours to 96 hours

Beyond the beneficial clinical results were multiple cost avoidance advantages 1:

  • Annual real cost savings of 34% ($188,640)
  • Nursing time decreased from an average of 25 to 15 minutes per procedure
  • Reducing phlebitis rates resulted in lower expenditures and fewer unscheduled restarts
  • Extending catheter dwell time protocols saved nursing time and materials
  • Standardization reduced risk of costly infections
  • No need to hire additional nursing staff

Furthermore, the study resulted in some patient benefits as well 1:

  • Increased comfort (ie, fewer site complications, skin tears, unscheduled restarts)
  • Increased safety/lower risk of infection

This study demonstrated that standardization of procedure kits can not only help with overall compliance to best practices, but provide clinical and financial benefits as well. As you determine the appropriate components for your kits (eg, gowns, masks, caps, gloves, drapes, dressings, site prep solutions, etc.), consider the inclusion of Mastisol® Liquid Adhesive and Detachol® Adhesive Remover for any kit containing wound closure tapes or dressings:

  • Mastisol® Liquid Adhesive: Reduce the risk of infection by creating a lasting occlusive dressing barrier by incorporating Mastisol®
  • Detachol® Adhesive Remover: Miniminze risk of skin injury by implementing Detachol® for safe dressing removal

There are many manufacturers that specialize in providing and customizing kits for facility-specific needs. Mastisol® and Detachol® are available components for many kit manufacturers.

For more information about Mastisol® and Detachol®, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1-877-433-7626 or visit www.eloquesthealthcare.com.

Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce risk of conditions like a CAUTI, CLABSI, or SSI.

Come back next time for the first of a 3-part series on catheter-related bloodstream infections (CRBSIs). You won’t want to miss it!

References

  1. Penny-Timmons E. Decreased costs/improved outcomes with standardized intravenous equipment. JAVA. 2005;10(1):20-23.

Procedure Kits Help Drive Compliance Best Practices

Most likely, your practice has standard operating procedures to ensure consistency and quality of care. In fact, an article in Modern Healthcare cited that 30% of inefficiencies in our healthcare system today are driven by a lack of standardization and a lack of care coordination.1

In the pursuit of creating “best practices” in your facility, one such area to consider is how procedure kits can help improve adherence. Two important advantages of doing so are:

  • Minimizing process variance so that all staff perform the procedure exactly the same way
  • Convenience of saving steps to locate and use materials independent of the procedure

PROCEDURES WHERE KITS HELP

  • Vascular Access Devices
  • PIV Starts
  • CVC Insertion
  • PICC Lines
  • Epidurals
  • Dressing Changes
  • Surgical Procedures

The Guidelines for the Prevention of Intravascular Catheter-Related Infections from the US Centers for Disease Control and Prevention (CDC) report that the risk for infection declines following standardization of aseptic care. Moreover, the insertion and maintenance of intravascular catheters by inexperienced staff potentially increased the risk for catheter colonization and catheter-related bloodstream infection (CRBSI).2

 

Standardized kits are also available for many surgical procedures and offer many of the same benefits of their vascular counterparts. Examples of these include incision and drainage (I&D) trays, arthroscopy kits, total knee replacement packs, and C-section setup packs. As the number of surgical procedures in the U.S. and the number of patients with increasingly complex comorbidities continues to rise, the stakes are becoming even higher.3

It is evident that standardization of procedure kits can help your practice or facility by having a positive effect on overall compliance to best practices. As you determine the appropriate components for your kits (eg, gowns, masks, caps, gloves, drapes, dressings, site prep solutionsetc), don’t forget to include Mastisol® Liquid Adhesive and Detachol® Adhesive Remover for any kit containing wound closure tapes or dressings:

  • Mastisol® Liquid Adhesive:  Reduce the risk of infection by creating a lasting occlusive dressing barrier by incorporating Mastisol®
  • Detachol® Adhesive Remover: Miniminze risk of skin injury by implementing Detachol® for safe dressing removal

There are many manufacturers that specialize in providing and customizing kits for facility-specific needs. Mastisol® and Detachol® are available components for many kit manufacturers.

For more information about Mastisol® and Detachol®, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1-877-433-7626 or visit www.eloquesthealthcare.com.

Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce the risk of conditions like a CAUTI, CLABSI, or SSI.

Join us next time to read our blog, “Procedure Kits: Where Common Sense Makes Financial Sense.”

References

  1. Standardizing care reduces costs, improves quality. Modern Healthcare. http://www.modernhealthcare.com/article/20150411/MAGAZINE/304119950. Published April 11, 2015. Accessed August 30, 2017.
  2. O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the Prevention of Intravascular Catheter-related Infections. Clin Infect Dis. 2011;52(9):e162-e193.
  3. Healthcare Infection Control Practices Advisory Committee. The Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg published online May 2017. Doi:10.1001/jamasurg.2017.0904.

Antimicrobial Dressings: The Silver Mystique

As mentioned in our last posting, SSIs are the most common and costly of all hospital-acquired infections in the US.1 If you happened to have missed it, read it here. Accordingly, efforts to reduce SSI rates have led to the development of post-op dressings with antimicrobial agents impregnated within the dressing. These dressing inhibit the growth of, or kill a broad spectrum of microbes, at the surgical site.2

Dressings currently on the market incorporate three different antimicrobial agents:

  • Polyhexamethylene biguanide (PHMB) is an antimicrobial agent used in wound dressings, contact lens solutions, mouth wash and perioperative cleansing products; PHMB kills microorganisms by disrupting the cell membrane3
  • Silver’s (Ag) antimicrobial properties stem from its ability to be absorbed into the microorganism and bind DNA, resulting in cell death2
  • Chlorhexidine Gluconate (CHG) has been used worldwide as an antiseptic since 19544 and is effective against a broad spectrum of gram-positive and gram-negative bacteria, yeasts, and some viruses; chlorhexidine is the active antimicrobial agent, and chlorhexidine gluconate is a commonly used form of chlorhexidine because it is colorless, odorless, and easily dissolves in water.5

A closer look at silver
The use of silver in wound care was documented as early as 69 BC.6 Silver has broad spectrum antimicrobial activity against bacteria, yeast, fungi and mold. Topical silver-containing creams and ointments have been a mainstay of wound management in burn patients for years.7 Silver has been incorporated into various medical devices, including hemodialysis catheters, endotracheal tubes and urinary catheters.5

In order to have an antimicrobial effect, silver must be in the form of a charged particle (or ion).2 These silver ions are absorbed by bacteria, which in turn bind to the DNA structures to affect cell function and respiration. The overall effect is an interruption of bacterial replication and reduced formation of colonies.

There is a wide range of silver dressings and their methods of antimicrobial action is diverse.2 The variations stem from those that actively deliver silver to the wound surface either in low or high concentrations, and others that retain and kill bacteria within the structures of the dressing.

While the industry has widely debated the safety of silver in relation to systemic absorption and toxicity to human cells, it is thought that this occurs when silver ions are released into the wound bed too quickly over a sustained period of time.2 It is important to note, however—that in extensive recent reviews—the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO,) and the Cochrane Library) found no evidence that the use of dressings containing silver reduces rates of SSI.8-10

The aim of post-operative wound care is to allow the wound to quickly heal without complications, avoiding unnecessary discomfort for the patient, minimizing scarring, and preventing blood loss.11-12 The choice of post-op dressing is a critical component of wound management. Attributes of an ideal wound healing environment dictate the characteristics of an ideal post-op wound dressing.

Be sure to join us next time for a big announcement from Eloquest Healthcare.

References:

  1. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224(1):59-74.
  2. Hewish J. Understanding the role of antimicrobial dressings. Wounds Essentials 2012;1:84-90. http://www.wounds-uk.com/pdf/content_10457.pdf. Accessed February 13, 2017.
  3. Mulder GD, Cavorsi JP, Lee, DK. Wounds. Medscape website. 2007;19:173-82. http://www.medscape.com/viewarticle/561512_3. Accessed February 15, 2017.
  4. Krishna MT, Huissoon A. Peri-operative anaphylaxis: Beyond drugs and latex. Int Arch Allergy Immunol 2015;167:101-21.
  5. ChlorhexidineFacts.com website. http://www.chlorhexidinefacts.com/the-molecule.html. Accessed February 15, 2017.
  6. Murphy PS, Evans GRD. Advances in wound healing: a review of current wound healing products. Plastic Surg Int. 2012: doi:10.1155/2012/190436.
  7. Parsons D, Bowler PG, Myles V, Jones S. Silver antimicrobial dressings in wound management: a comparison of antibacterial, physical, and chemical characteristics. Medscape website. http://www.medscape.com/viewarticle/513362_3. Accessed February 15, 2017.
  8. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Healthcare infection control practices advisory committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. eAppendix 2. JAMA Surg. Published online May 3, 2017. Doi:10.1001/ jamasurg.2017.0904.
  9. Allegranzi B, Zayed B, Bischoff P, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet. 2016;16:e288-303.
  10. Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection (review). Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD003091. DOI: 10.1002/14651858.CD003091.pub4.
  11. Yao K, Bae L, Yew WP. Post-operative wound management. Australian Fam Physic. 2013;42:867-70.
  12. Incision Care. Encyclopedia of Surgery Website. http://www.surgeryencyclopedia. com/Fi-La/Incision-Care.html. Accessed February 14, 2017.

SSIs and Post-Op Dressings: What’s Missing?

You might remember from our previous blogs that certain measures, like surgical site infections (SSIs) are penalized in multiple programs of the Affordable Care Act—in the Value-Based Purchasing Program as well as the Hospital-Acquired Conditions Reduction Program. View Blog #2 and Blog #3 here.

SSIs are the most common and costly of all hospital-acquired infections in the US.1 Approximately 160,000-300,000 SSIs occur each year in the US and each SSI is associated with approximately 7–11 additional postoperative hospital-days per infection.2 SSIs are believed to total $3.5 billion to $10 billion annually in healthcare expenditures.2

Morbidity rates of SSIs are also concerning. Seventy-seven percent of deaths in patients with an SSI are directly attributable to the SSI.2 And did you know that patients with an SSI have a 2- to 11-times higher risk of death compared with operative patients without an SSI?2

Post-operative dressings have become a critical component of wound management and prevention of SSIs. A number of dressings are currently available that offer variable levels of desirable features:

Basic wound contact dressings3

  • Absorbent dressings: applied directly to the wound
  • Surgical absorbents: used as secondary absorbent layers in the management of heavily-exuding wound

Advanced dressings3

  • Vapor-permeable films: permeable to water vapor and oxygen, but not to water or micro-organisms; normally transparent
  • Hydrocolloid dressings: occlusive dressings composed of a hydrocolloid matrix attached to a base (possibly film or foam); fluid absorbed from the wound causes the hydrocolloid to liquify
  • Fibrous hydrocolloid dressings: composed of sodium carboxymethyl cellulose, which forms a gel when it comes into contact with fluid
  • Polyurethane matrix hydrocolloid dressings: consist of 2 layers—a polyurethane gel matrix and a waterproof polyurethane film designed to act as a bacterial barrier

Antimicrobial dressings3

  • Polyhexamethylene biguanide (PHMB) dressings: impregnated with the antimicrobial agent polyhexanide
  • Topical skin adhesives (glue-as-dressing): for closure of minor skin wounds and additional suture support; also used on an already closed wound as a dressing without an additional covering
  • Silver dressings4: release silver ions to bind to the DNA structures to affect cell function and respiration, effecting the cessation of bacterial replication
  • Chlorhexidine Gluconate (CHG) dressings: effective against a broad spectrum of gram-positive and gram-negative bacteria, yeasts, and some viruses; chlorhexidine is the active antimicrobial agent, and chlorhexidine gluconate is a commonly used form of chlorhexidine because it is colorless, odorless, and easily dissolves in water.5
  • Iodine dressings4: thought to disrupt microbial enzymes, proteins, and cell membranes through reacting with cell amino acids
  • Honey dressings4: used for centuries for its broad spectrum antimicrobial activity and ability to reduce the potential for wound infection and accelerate wound healing

Differentiations in dressings include varying degrees and combinations of transparency, absorbency, antimicrobial agent, adherence, conformability and water-resistance. What we have yet to see in a post-op dressing is one that integrates absorbency, transparency and antimicrobial. Perhaps soon?

Join us next time for our blog, “Antimicrobial Dressings: The Silver Mystique.”

References:

  • Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224(1):59-74.
  • Anderson DJ, Podgorny K, Berrior-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:605-27.
  • Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection (review). Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD003091. DOI: 10.1002/14651858.CD003091.pub4.
  • Hewish J. Understanding the role of antimicrobial dressings. Wounds Essentials 2012;1:84-90. http://www.wounds-uk.com/pdf/content_10457.pdf. Accessed February 13, 2017.
  • ChlorhexidineFacts.com website. http://www.chlorhexidinefacts.com/the-molecule.html. Accessed June 1, 2017.

CAUTI Prevention: A Nurse-Driven Quality Improvement Study

As posted previously, the Affordable Care Act (ACA) established penalty measures for the performance of acute care hospitals. In fact, some measures are penalized in multiple programs1,2:

  • VALUE-BASED PURCHASING PROGRAM (VBP) – For more information about the VBP Program, see our previous blog
  • HOSPITAL-ACQUIRED CONDITIONS (HAC) REDUCTION PROGRAM – For more information about the HAC Reduction Program, see our previous blog.

According to the Centers for Disease Control and Prevention (CDC), urinary tract infections (UTIs) are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network.3

Among UTIs acquired in the hospital, approximately 75% are associated with
 a urinary catheter3

What can be done?
A poster, Taking the Next Steps for Patient Safety and Excellence in CAUTI Prevention, was recently presented at the 44th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).The poster described a nurse-driven quality improvement initiative designed to:

  • reduce urinary device days
  • decrease the Foley Utilization Rate (FUR), which is calculated by dividing the number of Foley catheter days by the number of patient days5
  • lower the CAUTI rate

The initiative sought to determine if switching from an indwelling (Foley) catheter to a different male external continence device (ECD) could reduce the negative outcomes associated with the Foley catheters.

The results of switching to an ECD resulted in:

  • a 46% decrease in total urinary device days
  • decreased the FUR from a high of 0.41 in to a low of 0.19 (with a 0.25 average)
  • lowered the CAUTI rate to 0 (See Figure 1 below.)

Figure 1. CAUTI Rate

The poster’s author noted some important clinical implications:

  1. Adherence to appropriateness criteria for indwelling catheter placement can help prevent unnecessary risk for CAUTIs.
  2. Use of an ECD as an alternative to indwelling Foley catheters may reduce the CAUTI incidence rate.
  3. The intervention resulted in an overall decrease in total urinary device days and Foley catheter days.

The ECD used and represented by an image on the poster was the ReliaFit® Male Urinary Device marketed by Eloquest Healthcare®:

The results clearly support the poster’s title and provide impressive rationale for taking proactive steps for preventing CAUTIs in the acute care hospital setting.  Download the poster here.

Come back to read our next blog, “SSIs and Post-op dressings: What’s missing?”

References:

  1. Hospital Value-Based Purchasing. Department of Health and Human Services, Centers for Medicare & Medicaid Services. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network- MLN/MLNProducts/downloads/Hospital_VBPurchasing_Fact_ Sheet_ICN907664.pdf. Published September 2015. Accessed June 1, 2017.
  2. FY 2017 HACRP Key Dates Matrix. Hospital-Acquired Condition Reduction Program (HACRP). Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html. Accessed June 1, 2017.
  3. Healthcare-associated Infections: Catheter-associated Urinary Tract Infections (CAUTI). CDC website. https://www.cdc.gov/hai/ca_uti/uti.html. Accessed June 1, 2017.
  4. Quayle BL. Taking the next steps for patient safety and excellence in CAUTI prevention. Poster presented at: APIC 44th Annual Conference. June 14, 2017; Portland, Oregon.
  5. Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events. CDC website. https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf. Published January 2017. Accessed June 1, 2017.

Hospital-Acquired Conditions (HAC) Reduction Program

Our last blog provided some background on the READMISSIONS REDUCTION PROGRAM —a three-year rolling process of reporting all-cause readmissions within 30 days of discharge, along with potential penalties.1  Today, we’ll look at the third program established by the Affordable Care Act (ACA): the HOSPITAL-ACQUIRED CONDITIONS (HAC) REDUCTION PROGRAM.

HAC REDUCTION PROGRAM allows the Centers for Medicare & Medicaid Services (CMS) to reduce payments by 1% to hospitals in the worst-performing quartile.2 The CMS reduces payments for specific safety issues and hospital-acquired infections3

  • CAUTI | Catheter Associated Urinary Tract Infection
  • CLABSI | Central Line Associated Bloodstream Infection
  • SSI | Surgical Site Infection
    • Abdominal hysterectomy
    • Colon surgeries
  • MRSA | Methicillin-Resistant Staphylococcus Aureus Bacteremia
  • CDI | Clostridium Difficile Infection

HACs are acquired by patients while receiving care and represent the most frequent adverse event affecting patient safety worldwide.4 For FY 2017, CMS estimated that overall payments to 769 hospitals would drop by roughly $430 MILLION.5

There are two domains associated with the HAC REDUCTION PROGRAM.3:

DOMAIN 1 is based on Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator (PSI) 90 Composite Component Measures and provides an overview of hospital-level quality as it relates to a set of potentially preventable hospital-related events associated with harmful outcomes for patients.6 It is weighted 15%.4

DOMAIN 2 includes standardized infection ratios (SIRs) calculated by the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Healthcare-Associated Infection (HAI) Measures.4 It is weighted 85%.4

Domain 1 is a weighted average of the 
risk- and reliability-adjusted versions of:

  • Pressure Ulcer Rate
  • Iatrogenic Pneumothorax Rate
  • In-Hospital Fall with Hip Fracture Rate
  • Perioperative Hemorrhage or Hematoma Rate
  • Postoperative Acute Kidney Injury Rate
  • Postoperative Respiratory Failure Rate
  • Perioperative Pulmonary Embolism (PE) or
  • Deep Vein Thrombosis (DVT) Rate
  • Postoperative Sepsis Rate
  • Postoperative Wound Dehiscence Rate
  • Unrecognized Abdominopelvic Accidental
    Puncture Laceration Rate

Domain 2 is Center for Disease Control’s (CDC) calculated standardized infection ratios (SIRs) for the CLABSI, CAUTI, and SSI measures. SIRs are ratios of observed-to-predicted numbers of HAIs. The CLABSI, CAUTI, and SSI measures are risk-adjusted at the hospital level and patient-care unit level:

  • CAUTI
  • CLABSI
  • SSI
  • Abdominal hysterectomy
  • Colon surgeries
  • MRSA Bacteremia
  • CDI

If you’ve been following our blog, you’ll probably remember that measures from Domain 2, which make up 85% of the weighting, are penalized in multiple programs—here, in the HAC Reduction Program as well as in the Value-Based Purchasing Program (VBP).

What’s the impact? Consider an average 300-bed Community Hospital with 48% of their patients being Medicare beneficiaries. If they have an inpatient Medicare revenue of $26,000,000 and received a $20,000 payment reduction for a condition/diagnosis, their 1% penalty reduction would be $200. That same reduction would be applied to EVERY inpatient Medicare claim submitted during the fiscal year and could result in a penalty of $260,000.

According to the CMS, there’s good news—improvements are being made. Across the last three fiscal years, 2015, 2016, and 2017, the average performance across eligible hospitals improved for the mean Catheter-Associated Urinary Tract Infection (CAUTI) standardized infection ratio (SIR) and the mean SIR decreased from 1.12 in FY 2015 and 1.17 in FY 2016 to 0.91 in FY 2017.7

If you’d like a comprehensive overview of the Affordable Care Act as featured in our last 4 blogs, click here to download the “True Transparency in the Cost of Care” infographic.

Come back next time when we review some of the latest clinical evidence on CAUTI risk reduction presented at the APIC Annual Conference 2017.

Minimizing infection risk is an essential part of optimizing “The Triple Aim” of the Affordable Care Act. Eloquest Healthcare is committed to providing solutions that can help you reduce risk of conditions like a CAUTI, CLABSI, or SSI.

References

  1. Understanding the Hospital Readmissions Reduction Program. The Lake Superior Quality Innovation Network, Centers for Medicare & Medicaid Services Quality Improvement Organization Program. https://www.stratishealth.org/documents/Readmissions_Reduction_Fact_Sheet.pdf.  Published November 2014. Accessed January 16, 2017.

  2. Hospital-Acquired Condition Reduction Program (HACRP). Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html. Accessed January 16, 2017.

  3. FY 2017 HACRP Key Dates Matrix. Hospital-Acquired Condition Reduction Program (HACRP). Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html. Accessed January 16, 2017.

  4. Health care-associated infections fact sheet. World Health Organization. http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf. Accessed March 30, 2017.

  5. Haefner M. 769 hospitals see medicare payments cut over high HAC rates: 7 things to know. http://www.beckershospitalreview.com/quality/769-hospitals-see-medicare-payments-cut-over-high-hac-rates-7-things-to-know.html. Published December 22, 2016. Accessed January 16, 2017

  6. PSI 90 Fact Sheet. AHRQ Quality Indicators. Agency for Healthcare Research and Quality. https://www.qualityindicators.ahrq.gov/News/PSI90_Factsheet_FAQ.pdf. Published FY 2016. Accessed March 30, 2017.

  7. FY 2017 HACRP Fact Sheet. Hospital-Acquired Condition Reduction Program (HACRP). Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/HAC-reduction-program.html. Accessed March 30, 2017.

A Breakdown of the ACA and What it Means to Your Hospital

The Affordable Care Act (ACA) created a national quality strategy for the triple aim of better care, healthy people and communities, and affordable care.1 It also initiated a significant transition from fee-for-service to value-based care.

Continue reading